What to do if you think your baby has an infantile hemangioma:
Infantile hemangiomas usually become noticeable by 4 weeks of age. They may start out looking like a tiny bump or scratch. But many then grow especially fast between 5 and 7 weeks old. If you think your baby might have a hemangioma, it’s best to contact your baby’s pediatrician right away. He or she probably will want to see your baby within a short timeframe. According to the AAP, the best “window of opportunity” to be evaluated and start treatment if needed is about 1 month of age.
Your pediatrician will want to know:
- Size: Is the hemangioma small (3/4″ or less across) or larger?
- Location:Is it located on the face or in the diaper area, or in a different area?
- Number:Is there one or more than one? If more than one, how many?
If your doctor can’t see you in the office right away, they may ask you to send photos or recommend a telemedicine visit to have a look without delay.
What to expect next:
It’s important to continue monitoring the hemangioma until it stops growing. Superficial hemangiomas typically reach their full size by 5 months of age, although deep hemangiomas sometimes keep growing a while longer. In some cases, your pediatrician may give a referral to an infantile hemangioma specialist with expertise in pediatric dermatology, hematology-oncology, otolaryngology, or plastic surgery.
By the time a baby is 6-18 months old, most hemangiomas begin to slowly improve. In a process called “involution,” the hemangioma will become less red and more grey or whitish and gradually flatten and shrink from the center outward.
Each case is different. Most hemangiomas have finished or almost finished flattening and shrinking by 4 to 5 years of age.
When does a hemangioma need to be treated?
Whether a hemangioma needs treatment depends on the age of the baby, where the hemangioma is located and how fast it is growing, whether it becomes sore or scabby, and the risk of it causing medical complications with a child’s health and well-being.
There are 3 main reasons for treatment:
- Medical problems. In rare cases and depending where they are located and how fast they are growing, hemangioma may begin to interfere with vital functions. Hemangiomas near the child’s eyes, nose or mouth, for example, can affect the child’s ability to see, eat, breath or hear well. In rare cases, hemangiomas grow inside the body, which may need to be monitored with imaging tests.
- Skin breakdown. Sometimes, skin on the hemangioma’s surface breaks down and becomes an open sore (called an ulcer) that could lead to bleeding, infection, or scarring.
- Permanent skin changes.Changes in the skin’s texture or color can remain even after the hemangioma has gone away. This can be a concern, especially for hemangiomas on the child’s face. Large hemangiomas on facial features such as the nose or lip can also distort growth.
